The maples and ferns are still incorrupt, yet, no doubt, when they come to consciousness, they, too, will curse and swear – Ralph Waldo Emerson, Nature, 1836.
The attention of Association of Medical Laboratory Scientists of Nigeria (AMLSN) has been drawn to the malicious, self-seeking, condemnable and highly fallacious article purportedly emanating from Nigerian Medical Association (NMA) captioned PUBLIC HOSPITALS ARE DEAD, DOCTORS WARN published in page 4 of the Guardian of March 10, 2016 and the Press Release captioned IMPENDING DISASTER AND COLLAPSE OF GOVERNMENT HOSPITALS AND THE PUBLIC HEALTH SECTOR: A CALL FOR IMMEDIATE ACTION AGAINST EXISTING AND EMERGING ABSURDITIES IN THE NATION’S HEALTH SECTOR and published in The Punch of Tuesday, March 15, 2016, pages 34 and 35, and a few other national dailies. AMLSN is amused at the mechanical aberrations of truths, promotion of falsehood, ridiculing of the Nigerian judiciary and the legislature as well as aberrant display of egocentric tendencies and grandstanding by NMA in the said publications. It is unfortunate and sad, that in the face of perverted reasoning, NMA felt she could commandeer anyone not only other health professionals in the health sector, but attempted to muzzle the constitution, the judiciary, the Office of the Head of Civil Service of the Federation and the extant laws to suit their insatiable whims and caprices.
Ordinarily, the Association of Medical Laboratory Scientists of Nigeria (AMLSN) would have ignored the hogwash as it is already in the litter bin of sane Nigerians but for the magnitude of misinformation and failed attempts to portray Medical Laboratory Science profession as an appendage of pathologists (Medical Doctors), AMLSN therefore feels duty bound to clear the air. This clarification is also necessary in order to save Nigerians who could be misled by the tears of the lamenting NMA which we advised, should be treated by the public as ‘the ranting of a drowning man’.
In their vain attempts to maintain the posture of know-it-all, NMA blamed, derided, indicted and insulted the judiciary and the learned and respectable judges in Nigeria by shamefully and wrongfully accusing them of being bought over by other health professionals to pervert justice. NMA must be made to prove these weighty allegations against the eminent judges; else, she (NMA) stands the risk of libelous litigation(s) by the respected jurists. NMA practically told the judiciary that they erred in passing the recent judgments simply because none went their way. While NMA allegations may appear hard on the judiciary, their accusations in the said publications are to further buttress the overbearing nature of the NMA in deriding other professionals that are not medical doctors. We would not be surprised if NMA wakes up tomorrow to say her members can do the work of judges in the National Industrial Court of Nigeria (NICN) and Supreme Court judges more than the eminently qualified and licensed judges/ justices just as they have shown unbridled proclivity in the hospitals for headship of Accounts, Security, Maintenance, Pharmacy, Nursing, Medical Laboratories, Optometry and every other departments in the hospitals.
The fact is that, Medical Laboratory Scientists and other health professionals are distinct and separate from medical doctors whose profession is medicine/surgery. It has been clearly pronounced by various courts of competent jurisdictions that the era when medical doctors treat other health professionals as ‘errand boys’ and ‘girls’ or ‘slaves’ is gone and gone forever and that every profession, especially Medical Laboratory Science is separate, distinct and autonomous from medicine/surgery; capable of administering, supervising and heading their practice.
Sadly too, NMA criticized and brandished the legislative arm of government as incompetent with false allegations that the legislature has been hijacked and it is colluding with other health professionals to hastily pass laws and upgrading training courses of health professionals without due legislative processes. This obviously is insulting to the distinguished Senators and Honourable members of House of Representatives where laws are made. This is tantamount to accusing the legislatures of knowing nothing in legislative business.
NMA has refused to appreciate advances that have been made in Medical Laboratory Science profession, Pharmacy, Physiotherapy, Nursing, Imaging Science etc; they forgot too, that medicine/surgery itself, started as a diploma program before undergoing metamorphosis through legislative processes to what it is today. Unfortunately, the ladder they used to climb to the top is what they want to destroy so that others will not find anything to climb up with. What a wicked disposition. NMA should live and let others live too!
It is laughable to read that NMA expected that other health professionals should not be elevated to the zenith of their profession citing high wage bill as the reason. While regulatory bodies and government establishments saw the need to upgrade courses for improved services, only NMA sees capacity development as quest for pay rise. No wonder they have been on the neck of government with all manner of demands for pay-rise and entry points while the health system rots due to mismanagement with billions of dollars wasted by Nigerians on medical tourism. Good administrators look at capacity development in terms of what it will bring to service delivery and productivity but NMA alone sees capacity development in terms of how much money comes into the pocket. This is laughable.
They also alleged that “frivolous courses and programs with no relevance to hospital and indeed the healthcare industry were quickly developed and accredited for other health professionals…” this is ludicrous, especially the jaundiced insinuation that “duration of training have been elongated as a way of measuring the medical training…” While NMA failed to point out such “useless” programs in the health sector that other health professionals engage in, their submission has clearly demonstrated their deep seated envy against other professionals and their desire to keep everyone down while they alone soar. Just imagine what rationale for moves to extend the years of MBBS training to ten or eleven without any addition to scope of learning. This is a desperate attempt to give a false impression that they spend more years in the university, and so, should earn more than others in the health sector.
Signing of laboratory results by Pathologists: NMA went ultra vires in their write-ups directing their colleagues not to use results of completed Medical Laboratory tests performed, reviewed and signed by licensed Medical Laboratory Scientists but not counter-signed by pathologists who professionally, contributed nothing to the generation of such results. Let Nigerians ask NMA to display the law that empowers them to conduct laboratory tests, sign laboratory results or supervise Medical Laboratories. Nigerians should also ask them if they are registered and licensed by the Medical Laboratory Science Council of Nigeria (MLSCN) to do the work of Medical Laboratory Scientists. As it stands today, only MLSCN is saddled with the task of inspection, monitoring, accrediting, and regulating the PRACTICE of Medical Laboratory Science in both public and private hospitals in Nigeria. Funny enough, the enabling law for Medical and Dental Council of Nigeria (MDCN) which is the regulatory body for all medical doctors in Nigeria) does not give MDCN power to inspect, monitor or accredit clinics and hospitals (which they should have requested to have , at least, to flush out substandard hospitals and clinics that are daily killing innocent Nigerians) yet pathologists through NMA, erroneously deceived Nigerians that MDCN had power to regulate clinical laboratory practice whereas the MDCN law only empowers them to regulate clinical laboratory PRACTICALS for the purpose of teaching medical students in the field of pathology. While we are aware that NMA is attempting to alter the word ‘PRACTICALS’ in their enabling law to ‘PRACTICE’, we anxiously await them to do that and use the wrath of the laws of the land to sweep them to prison for attempted forgery and twisting the law of the land to achieve illegal goal for their members. NMA and her cohorts must be told that there is always an end to impunity.
Duties of Medical laboratory Scientists and the Pathologists in the care/management of patients: The duties of the two autonomous professionals are quite distinct and separate from one another. It is likened to the duties of an Architect and a Builder – two distinct professionals in the building industry. It is quite obvious that NMA does not understand the duties of the pathologists in the care and management of patients and they were merely exhibiting solidarity for their colleagues, the pathologists. If they did, they would not have claimed that “pathology and Medical Laboratory Science professions are related” even when the Laws establishing these professions are different and separate and their schemes of service are separate and distinct. Medical Laboratory Scientists read Medical Laboratory Science in the university while pathologists read Medicine and Surgery in the university just as Pharmacists read Pharmacy in the university etc. Recent court judgments in favour of Medical Laboratory Scientists have pronounced Medical Laboratory Science as a distinct and separate profession from Medicine/Surgery.
It is laughable to say that pathology, a branch of medicine which should concern itself with practicals during the training of medical students and pathologists running special clinics based on the findings from the patients’ tests performed, reviewed and signed by Medical Laboratory Scientists or performing post mortems for dead bodies or conduct ward rounds with their doctor colleagues so as to advise them on how best their physician colleagues should interpret laboratory test results in the treatment or management of the patients. Rather than performing all these duties as medical doctor/pathologists, they abandoned their duties and instead, are now claiming authority over Medical Laboratory Scientists whose scheme of service and law empower them to legally perform routine and specialized analysis of patients’ samples in the laboratory, total management of the laboratory to ensure high quality test results among other duties, for the purpose of making such results ready for use by physicians in the treatment or management of patients and for several other purposes.
For proper records and the need to convey the truth to the enlightened public, AMLSN wishes to summarize as follows:
Further insults to the office of the Head of Civil Service of the Federation, the judiciary and the legislatures should be stopped by NMA: NMA in all their said publications insulted the psyche of the Office of Head of Civil Service of the Federation from where circulars and schemes of service for different professionals are released, the legislature where laws are made and the judiciary that interprets the laws of the land. Obviously, these were among the several attempts to enslave other health professionals by NMA. All other health professionals will continue to pay due respects to these esteem officers and will continue to treat the judiciary as the last hope of the common man and the oppressed.
The Pathologist have no business counter-singing the results of ledical laboratory tests performed, reviewed and signed by licensed Medical Laboratory Scientists: The directive by NMA to their members that any medical laboratory test not signed by pathologist should not be used for the care of patients is insulting to the intelligence of all Nigerians. It is an affront on the various judgements of the National Industrial Courts of Nigeria. The claim by NMA had been roundly deflated by the various judgements delivered by eminent judges on cases all ruled in favour of Medical Laboratory Scientists. It is surprising that NMA, in an attempt to express unwarranted solidarity for their colleagues (the pathologists), directed their members to ignore judicial pronouncements in the cases determined between Medical Laboratory Scientists and the pathologists and were all separately ruled in favour of Medical Laboratory Scientists. This is one of the several examples of lawlessness and impunity which some of the elements in NMA have been encouraging and promoting.
Privatization and outsourcing of hospital services: This will make health services to be out of reach of the common man by increasing the out-of-pocket health expenses of Nigerians especially the poor masses, and hinders universal health coverage which is envisaged to be affordable, available and accessible to the citizenry. The directive by NMA that laboratories, pharmacies, x-rays and other services rendered by other health professionals except those rendered by medical doctors, should be privatized and outsourced by Chief Medical Directors CMDs and Medical Directors (MDs)-who are also NMA members in all government hospitals, is a further display of selfishness. They further directed in their publications under reference that CMDs and MDs should explore the patronage of private laboratories outside the public hospitals. This directives by NMA, was clearly affirming the opinions of other health professionals such as Medical Laboratory Scientists, Radiographers, Pharmacists, Physiotherapists, Nurses etc that the CMDs and MDs are being used by NMA to destroy or kill other health professionals and their services in public hospitals through PPP; and not out of genuine concerns for Nigerians. It is worthy of note that if PPP policy of government is to be adopted, then, it should be in line with the set guidelines of the Federal Government and must be for all the professional services in the health sector including the services rendered by the medical doctors and should not be selective against a particular profession or group of professions.
Who then has killed or is killing the public hospitals in Nigeria: Nigerians should now clearly know who has killed or is killing the public hospitals and making health services to be out of reach of the masses. Health services which are inalienable rights or social services to the masses by any caring governments at all levels, are now being recommended for privatization and commercialization by NMA, out of selfish interest, ego and disregard for professionalism in health sector. The strong advocacy for PPP by NMA is perhaps to make some of the NMA members richer through commissions and inducements which such private investors usually give them as a reward for sending patients (or patients’ samples) to private laboratories, X-ray centers, pharmacies etc. Some of them would not even refer patients to centres that would not give them returns in form of rebates or commissions.
This, usually, is at the expense of the poor masses. That could be a major reason why the public hospitals are being killed by members of NMA. They are in actual fact, the ones killing the public hospitals; yet they cry foul that the public hospitals are dead! Some of them even refer cases that could be rather managed in Nigeria to foreign hospitals due to likely commissions for patronage. Thus, encouraging and promoting unnecessary and avoidable medical tourism. Insistence on their rights and privileges by other professionals in the health sector cannot be attributable to death of public hospitals as NMA attempted to portray.
Yayale Ahmed committee reports: It is laughable to note that while NMA was quick to condemn judgements of courts of competent jurisdiction, condemned eminent judges for upholding the rule of law, vehement in rejecting Justice (rtd) Abdullahi Gusau’s committee’s report, oppose implementation of government circulars and scheme of service for Medical Laboratory Scientists and other health professionals in health institutions, it was selfishly calling for a white paper on Yayale Ahmed’s committee’s report which has been roundly condemned by other health professionals. No doubt, the Yayale Ahmed committee’s report in its present form, grossly promotes enslavements of other health professionals in her recommendations. Yayale Ahmed committee’s report cannot replace judicial pronouncements by eminent judges of courts of competent jurisdiction in cases already determined and ruled in favour of Medical Laboratory Scientists against the pathologists. Any white paper based on the recommendations of the Yayale Ahmed committee that is at variance with judicial pronouncements and laws regulating the practice of other health professions would not and shall not be accepted by AMLSN and other health professionals!
The various professionals in the health sector are no slaves. The various professionals in health sector will and shall always resist injustice, inequity, impunity and lawlessness which NMA is advocating in favour of their colleagues who are medical doctors.
Where court judgments were not obeyed and respected, schemes of service and circulars for the various health professionals released by the Office of the Head of Civil Service of the Federation were ignored, rights and privileges of other health professionals were denied by NMA members because majority of CEO of the health institutions are NMA members, then, that could be seen as ‘living in the jungle’ and an open invitation to anarchy in the health sector.
The era of slavery and impunity in the health sector is gone and gone forever!
Conclusion: Nigerians should rise up against the overbearing attitude of the Nigerian medical doctors and tell them the naked truth that they have mismanaged themselves, the medical team as well as the hospitals. Nigerians should also tell them to adjust and respect the reality of today that abhors professional ego, they should supports professionalism and not ‘jacks of all trades’ They should abide by the recent judicial pronouncements in favour of Medical Laboratory Scientists and or other professionals in health sector or risk imprisonment for contempt of court.
NMA should live and let other health professionals live too, for the sake of quality health services in Nigeria. The sky is so large to accommodate everybody!
Alh. Toyosi Y. Raheem Surajudeen A. Junaid (PhD) Tam Adetunji Adeyeye
National President National Secretary National. Public Relations Officer